Smith-Jones

Medical Evidence and Pre-Medical Offers

Introduction

Medical evidence is crucial when looking to pursue any sort of claim for personal injury. As this evidence can provide proof of the injuries sustained, the extent of these injuries and can even indicate how long the injuries may take to heal. This blog will look at the importance of medical evidence, and the dangers associated with pre-medical offers.

What are pre-medical offers?

If a driver is injured in an accident, the insurance company of the at-fault party may make a pre-medical offer. But what exactly does this term mean? A pre-medical offer is one made in the early stages of a claim before any medical evidence has been obtained, in an attempt by the insurance company to reduce the damages and costs payable by them and close the claim as soon as possible. There are many disadvantages to pre-medical offers which will be discussed at length below.

Which types of accident are pre-medical offers most likely to be made on?

In theory, a pre-medical offer can be made on any type of claim. Every driver, retail store, local council and employer is obligated to take out insurance to cover the risk of any accidents occurring.

However, victims of road traffic accidents who sustain soft tissue injuries are more likely to receive a pre-medical offer than claimants who have suffered from any other type of accident such as a serious head injury, see here. A Government consultation was published in February last year proposing reforms to the claims process, including proposals for a prohibition on pre-medical offers on the grounds that they are unhelpful to genuine claimants, can lead to under-settlement and that they encourage fraudulent behaviour.[1]

 

The importance of medical evidence

Medical evidence is mainly used to demonstrate what injuries were sustained, how long injuries lasted, and the treatment or medication required for the injuries to heal. This evidence includes, but is not limited to:

  • GP records
  • Hospital records
  • X-rays
  • Prescription forms
  • Medical reports

First and foremost, medical evidence serves as an official record that an accident has occurred and that injuries have been sustained. GP and hospital records are particularly useful in determining the severity of injuries which have occurred.

Furthermore, medical evidence can be used to determine how an injury is likely to progress and for what length of time it will progress. A medical report from an independent expert is particularly useful in assessing the length and likely course of injuries as well as providing recommendations for treatment.

In some instances, a medical report may even provide an opinion of who or what is responsible for an accident occurring.

Medical evidence is extremely important when you are looking to pursue a claim for personal injury. It is often used to assess the injuries which have occurred and evaluate the amount of compensation available for those injuries. Consequently, when insurers forgo medical evidence in order to make an early offer, it is often to the disadvantage of the injured party.

 

Disadvantages of pre-medical offers

There are quite a few disadvantages when it comes to accepting a pre-medical offer. It is important that you consider all of these before deciding whether to accept an early offer

A claimant looking to make a personal injury claim may only do so if they have not already pursued a claim for that accident. If an offer is accepted in settlement of a claim, that claim cannot be revisited, and no further compensation can be gained. Pre-medical offers are often low, and not at all indicative of the true value of a prospective claim. This can leave that potential claimants feeling rather disgruntled when they find out that they could have claimed more if they had sought the advice of a solicitor.

Further problems present themselves if the potential claimant has sustained quite serious injuries which require a lot of medical attention. Not all injuries are immediately apparent, as such you should exercise caution and make sure you have recovered fully before you accept an offer to settle. In the context of serious injury, if the potential claimant accepts a pre-medical offer before they have fully recovered and later faces further difficulty, then they may be barred from pursuing a claim for any associated treatment costs. It is in your best interests to make sure that you have fully recovered, or have a clear prognosis, before looking to settle a claim for compensation. However, some insurer’s may try to settle the claim early to save on the amount of damages and costs they have to pay.[2]

After an accident occurs many claimants need time off work to recover which can result in a loss of earnings. As a result of this, claimants may be more inclined to accept pre-medical offers from insurers as a form of immediate gratification to make up for any lost money. However, in doing this they risk their claim being undervalued. A solicitor will be able to take into account all of the costs resulting from an accident, including the costs of future treatment, medication, and loss of earnings. Whereas an early offer may not allow for all of these associated expenses.

The Law Society launched a campaign back in 2013 aptly named ‘Don’t get mugged by an insurer’ which urged consumers to seek independent legal advice before accepting an offer to settle made by the insurers.[3] This was launched after figures from the Financial Services Authority (now the Financial Conduct Authority) showed that those who turned down an insurers initial offer and took legal advice received approximately three times more compensation. These figures demonstrate that insurers will in fact make low offers and that it is better to seek the advice of a solicitor.

As previously mentioned, the government published a consultation in February 2017 proposing reforms to the soft tissue injuries claims process.[4] In this report, there were concerns that pre-medical offers encourage minor, or even fraudulent claims to be made.[5] The availability of these offers without looking into any available medical evidence only serves to encourage opportunistic claims[6] and further fuels the very ‘compensation culture’ that insurers would have us believe exists.[7] In this view, the careless offering of an early settlement could result in money being taken away from claimants who actually need it, instead satiating the greed of those who would fraudulently make a claim.

 

Conclusion

Pre-medical offers are made without any investigation into medical evidence or accident circumstances. Proposing a settlement without looking into the available medical evidence can lead to claimants being under-compensated or even fraudulent claims being made. Accepting such an offer can have disastrous consequences for claimants who requires future treatment or time off work. So, while these offers appear attractive at the outset, they are anything but, and it is advised that you seek the advice of a solicitor if you are looking to pursue a claim for personal injury. Pursuing a claim through a solicitor will enable you to take account for all expenses incurred due to an accident, and will enable you to get the compensation that you are entitled to.

[1] Ministry of Justice, Part 1 of the Government Response to: Reforming the Soft Tissue Injury (‘whiplash’) Claims Process (Cm 9422 2017) para 100 – 101 <https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/593431/part-1-response-to-reforming-soft-tissue-injury-claims.pdf>

[2] You Could Save, ‘Insurers act in their best interests not yours’ (Published 25th July 2013) <http://www.youcouldsave.co.uk/insurers-act-in-their-best-interests-not-yours/>

[3] Law Society, ‘Law Society launches bold new advertising campaign for personal injury’ (Published 24th June 2013) <https://www.lawsociety.org.uk/news/press-releases/law-society-launches-bold-new-advertising-campaign-for-personal-injury/>

[4] Ministry of Justice, Part 1 of the Government Response to: Reforming the Soft Tissue Injury (‘whiplash’) Claims Process (Cm 9422 2017) <https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/593431/part-1-response-to-reforming-soft-tissue-injury-claims.pdf>

[5] Ministry of Justice, Part 1 of the Government Response to: Reforming the Soft Tissue Injury (‘whiplash’) Claims Process (Cm 9422 2017) para 102 <https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/593431/part-1-response-to-reforming-soft-tissue-injury-claims.pdf>

[6] Civil Justice Council, Civil Justice Council response to Insurance Task Force interim report (Published 15th May 2015) 2 <https://www.judiciary.gov.uk/wp-content/uploads/2011/03/cjc-insurance-fraud-response.pdf>

[7] The Law Society Gazette, ‘“Pre-medical” offers result in injustices’ (Published 11th March 2014) <https://www.lawgazette.co.uk/comment-and-opinion/pre-medical-offers-result-in-injustices/5040312.article>